Patients complain enough already about the intrusion of IT into the consulting room. How the doctor spends all his time “looking at the damn computer.” But an audiobook I’m “reading” and a new research project from Stanford make me wonder when there’s going to be nothing but a computer.
The audiobook is fantasy. Cell by Robin Cook, a slightly goofy story in which an “i-Doctor” app and a very smart phone will monitor your health 24/7, anticipate or diagnose any illnesses. Even fax the appropriate prescription to the pharmacy – replacing the need for you to actually have a doctor.
The Stanford research is reality. They built an algorithm called CheXNet, then showed it more than 100,000 chest X-rays and let it figure out how to diagnose pneumonia.
Then they, pitted it against 4 Stanford radiologists to interpret 420 Chest X-rays.
And yes, you’ve guessed it. CheXNet “outperformed” the radiologists in its ability to diagnose pneumonia, according to the Stanford News website.
In another study, an algorithm proved better than the American College of Cardiology/American Heart Association guidelines for predicting who was going to have a heart attack.
Unlike computers, humans are fallible. They get forgetful, rushed, tired. They need time off. Worst of all they are inconsistent.
In a study reported in JAMA in 2015, pathologists looking at samples of possible breast cancers. They only agreed 48 per cent of the time in the most difficult cases. Not very reassuring when you want to know for sure if you’ve got cancer or not.
Google is developing an algorithm that is claimed to be better. Better than humans at interpreting histological slides of breast tumors.
In another study, doctors were quizzed about cases they had diagnosed with stomach ulcers previously. But they often didn’t even agree with their own diagnosis and came up with a different one.
Computers don’t have these failings. They can plug away 24/7, and can be self-educating. Learn from their mistakes, and improve themselves all the time.
“Technology compensates for human deficiencies” notes Ajan Reginald, CEO of biotech company Celixir. “Eventually, computers will replace 80% of what doctors do . . . . . . we'll need fewer doctors, and every patient will receive the best” is what he predicts.
A Doctor at Home
The company, Catalia Health has already come up with an interactive “personalized healthcare robot,” they named Mabu (derived from two Japanese words – mabutaki meaning to blink and mabudachi meaning best friend) – a small, ugly yellow critter, with huge eyes (presumably why mabutaki), that sits on your desk top looking like a cross between ET and a Teletubbie, but which “learns about each patient’s personality, interests and treatment challenges . . . . .to create conversations that are tailored to each patient and that resonate with their unique personality and circumstances.”
Then there’s RP-VITA (Remote Presence - Virtual Independent Telemedicine Assistant) a self-propelled robot programmed to do rounds and visit patients in the hospital – with its interactive video screen, ability to gather and transmit vital sign data, even its own stethoscope.
People complain enough about their doctor just using a computer. What will they think when their doctor is a computer?
Reports on another RP-VITA-like robot called “Mr. Rounder” are surprising. “Patients really like him,” says Garth H. Ballantyne, M.D., of Hackensack University Medical Center.
In Robin Cooks book, people like “i-doctor” because, like your cell phone, it is always available.
Given the dour predictions about shortage of primary care doctors, it may be that you will have to make do with a “virtual-doctor.” But there’ll be none of this “we can fit you in in two weeks” and sitting for hours waiting for Dr. Wonderful.